R Jawish1, A Kahwaji, G Dagher. 1. Service de Chirurgie Orthopédique, Hôpital du Sacré-Coeur, BP 116, Hazmieh, Beyrouth, Liban. rjawish@cyberia.net.lb
Abstract
PURPOSE: The purpose of this work was to define the role of different factors which can accelerate overgrowth of femoral fractures in childhood. MATERIAL AND METHODS: Fifty-one fractures of the femur observed in 28 boys and 23 girls, mean age four years, were treated orthopedically. Twelve fractures involved the upper third of the femur, 34 the middle third and five the lower third. There were 30 transverse, 13 oblique, and eight spiral fractures. Overgrowth (OG) was assessed on x-rays obtained two years after bone healing and defined as the sum of the initial shortening (RI) plus leg length difference (LLD): OG=RI + LLD. RESULTS: OG was 11.3 mm in boys and 7.55 in girls, mean 9.5 mm. OG was greatest between the ages of 3 and 7 years. OG was 18.62 mm in spiral fractures, 9.15 mm in oblique fractures and 7.59 mm in transverse fractures. OG was 12.41, 9.46, and 2.49 mm for the upper, middle, and lower femur. Mean OG was 5.46, 9.43, and 18.09 mm for RI<5 mm, 5 mm<RI<10 mm, and RI > 10 mm respectively. There was a linear relationship between RI and OG: OG=0.84 RI + 3.4. DISCUSSION: Taking into account different factors, bony overgrowth can be estimated from the initial shortening in fractures of the femur in children. It is tolerated better in boys, between the age of 3 and 7 years, and for proximal and spiral fractures.
PURPOSE: The purpose of this work was to define the role of different factors which can accelerate overgrowth of femoral fractures in childhood. MATERIAL AND METHODS: Fifty-one fractures of the femur observed in 28 boys and 23 girls, mean age four years, were treated orthopedically. Twelve fractures involved the upper third of the femur, 34 the middle third and five the lower third. There were 30 transverse, 13 oblique, and eight spiral fractures. Overgrowth (OG) was assessed on x-rays obtained two years after bone healing and defined as the sum of the initial shortening (RI) plus leg length difference (LLD): OG=RI + LLD. RESULTS: OG was 11.3 mm in boys and 7.55 in girls, mean 9.5 mm. OG was greatest between the ages of 3 and 7 years. OG was 18.62 mm in spiral fractures, 9.15 mm in oblique fractures and 7.59 mm in transverse fractures. OG was 12.41, 9.46, and 2.49 mm for the upper, middle, and lower femur. Mean OG was 5.46, 9.43, and 18.09 mm for RI<5 mm, 5 mm<RI<10 mm, and RI > 10 mm respectively. There was a linear relationship between RI and OG: OG=0.84 RI + 3.4. DISCUSSION: Taking into account different factors, bony overgrowth can be estimated from the initial shortening in fractures of the femur in children. It is tolerated better in boys, between the age of 3 and 7 years, and for proximal and spiral fractures.